Functional medicine model improves quality of life scores, study finds

Functional medicine is associated with improvements in health-related quality of life, according to a new study by researchers at the Cleveland Clinic in Ohio and published in the in the Journal of the American Medical Association Network Open.

The two-year study examined 1,595 patients treated in Cleveland Clinic's Center for Functional Medicine and 5,657 patients seen in primary care at a family health center, assessing health-related quality of life using the Patient-Reported Outcomes Measurement Information System (PROMIS), a National Institutes of Health-validated questionnaire. PROMIS provides a measure of patients' global physical and mental health that can be monitored over time, measuring factors like fatigue, physical function, pain, gastrointestinal issues, and emotional wellbeing.

The study investigated the association between the functional medicine model of care and health-related quality of life by comparing functional medicine patients with patients seen in a primary care setting.

Researchers found that patients seen by the Center for Functional Medicine showed beneficial and sustainable improvements in their PROMIS global physical health. At six months, patients seen by the center exhibited significantly larger improvements in PROMIS global physical health compared to those seen in a primary care setting.

Additionally, approximately 31 percent of patients seen by the center improved their PROMIS global physical health scores by five points or more, which is a clinically meaningful change and a noticeable effect on daily life. Twenty-two percent of primary care patients improved their scores by five points or more. At 12 months, patients seen by the center showed improvement similar to that observed at six months, but these were not significant when compared with the improvements seen in primary care patients.

To examine this further, researchers evaluated continuous changes over time in PROMIS global physical health in a smaller group of patients seen by the center at both six and 12 months and demonstrated improvements in PROMIS global physical health that were significantly larger compared to patients seen in a primary care setting.

Researchers believe that reasons for the improvements in health-related quality of life shown in the functional medicine patients include differences in the functional medicine model itself, the types of patients seeking functional medicine, and treatment adherence or belief in the model of care. Future prospective studies are needed to examine the functional medicine model of care and long-term outcomes.